Office care of the premature infant

The family physician should follow the small premature infant in the neonatal intensive care center and review the baby's problems and risk factors. In the office, special attention is required in monitoring the infant. Proper hospital and office care greatly improve the prognosis.     

Laterality of cross-modal spatial processing

This study examined the laterality of spatial-form perception in normal adults using a cross-modal matching paradigm involving visual and tactile processing. Randomly generated eight-point and 12-point Vanderplas and Garvin (1959) patterns were used as the stimuli. In a visual-to-tactile task, a lateralized visual pattern was followed immediately by a haptic task requiring subjects to discriminate which of two simultaneously felt shapes matched the visual pattern. In a tactile-to-visual task, subjects decided which of two simultaneously felt shapes matched a lateralized visual pattern presented after haptic manipulation. There were no main effects for laterality or for sex differences. Matching accuracy was better in the visual-to-tactile task and for less complex stimuli. A visual field by feeling hand interaction showed best recognition accuracy when visual-feeling hand combinations on the same side of the body were used in the two matching tasks. These data reflect a stimulus-response compatibility explanation of spatial-form perception that is consistent with a behavioral and not a cerebral asymmetry model.     

Peripheral neuropathies during treatment with cisplatin: clinical and electrophysiologic study of 11 cases

Eleven patients with bronchial epidermoid carcinoma and undergoing treatment with cis-D.D.P. (II) were kept under electrophysiological and clinical surveillance. No other neurotoxic medication was added. The total dose of cis-D.D.P. was 300 mg/m2 over a period of three months: namely, three courses of 100 mg/m2 distributed over 5 days. Following the pretreatment check-up, the patients were divided into two groups: those without any electrophysiological abnormality (group A), and those without clinical abnormality but with a delayed latency H of the Hoffmann Reflex (group B). Patients in group A showed a slowing down of the motor nerve conduction velocity of the Median and Peroneal Nerves after a course of 100 mg, without accompanying worsening of the conduction velocity after 300 mg/m2, and prolongation of the distal latency of the sensory Median Nerve after 300 mg/m2; in group B, no significant change of electrophysiological clinical features were noted. In the two groups a non-significant reduction in amplitude of evoked responses were noted. These findings are more consistent with an axonal injury than with functional myelin injury. The authors review the existing literature and discuss the physiopathologic mechanisms of cis-D.D.P. peripheral neuropathies.     

Disabled and nondisabled infants' interactions with their mothers

This study investigated social interactions between infants and mothers, comparing dyads with physically disabled infants and dyads with nondisabled infants. The groups were matched on mental and motor development, sex, socioeconomic status, birth order, and maternal education. Each infant-mother dyad was videotaped at home during a 10-minute period of free play, and blind observers subsequently transcribed infants' and mothers' behaviors. In general, the groups were remarkably similar in their interaction patterns. However, a few differences emerged: Mothers of infants with physical disabilities were significantly more commanding than were comparison mothers. Nondisabled infants tended to engage in more eye contact than did infants with physical disabilities. And whereas mothers of nondisabled infants responded to interactive play with interactive play, mothers of infants with physical handicaps tended to respond with commands and verbalizations. These results suggest reciprocal influences between infants and mothers in both groups and highlight emerging maternal behavior patterns that may interfere with the development of communication and independence in handicapped young children.     

Effects of deoxynivalenol (vomitoxin) on the humoral and cellular immunity of mice

Sublethal doses (0.00, 0.25, 0.50 and 1.00 mg/kg b.w./day) of vomitoxin (deoxynivalenol; DON) were studied for their effects on humoral and cellular immunity and serum proteins of inbred, male Swiss Webster mice in a series of 4 separate experiments. Vomitoxin was added to basal diet (less than the detection limit, i.e., less than 0.05 micrograms of vomitoxin per g of feed) and administered to mice for 5 weeks beginning at 21 days of age. Mice in experiment 2 were fed the basal diet for 40 days in addition to the 5-week treatment with vomitoxin. The 1.00 mg/kg dose of vomitoxin resulted in a statistically significant reduction in the serum levels of alpha 1 and alpha 2-globulins, an increase in total serum albumin, and a reduction in feed consumption and body weight gain compared to the control group. The 0.50 mg/kg dose of vomitoxin resulted in significantly reduced serum levels of alpha 2- and beta-globulins while a significant reduction of feed consumption was evident only during Week 4. Similarly, body weight gain in this group of mice was significantly reduced during Week 2 but increased to normal levels during Week 3 and remained parallel to the control for Week 4 and 5. Both levels (0.50 and 1.00 mg/kg) of vomitoxin resulted in a reduced, dose-related, time-to-death interval following a challenge with L. monocytogenes and increased proliferative capacity of splenic lymphocyte cultures stimulated with the phytohemagglutinin P (PHA-P) mitogen compared to the control group of mice. The 0.25 mg/kg dose of vomitoxin did not have any significant effects on the parameters studied. A reasonable estimation of a 'no effect' level for immunologic effects in mice based on these and previous immunological studies would seem to be between 0.25 and 0.50 mg/kg b.w./day.     

Wheat Germ Agglutinin is Mitogenic, Non-Mitogenic and Anti-Mitogenic for Human Lymphocytes

Wheat germ agglutinin (WGA) was found to stimulate DNA synthesis in human peripheral blood mononuclear cells at relatively low concentrations and to inhibit DNA synthesis at higher concentrations. Both actions were inhibited by oligomers of N-acetyl-D-glucosamine. Significant mitogenic activity was dependent on the use of human (as opposed to fetal calf) serum to supplement the culture medium. Purified T cells responded to WGA very weakly and the incorporation of thymidine into non-T cells in response to WGA was less than the lectin-free control. The full ability of T cells to respond to WGA was restored by the addition of monocytes, but not by any other blood cells. Interleukin 2 partially restored the ability of T cells to respond to WGA; interleukin 1 was less effective. WGA displayed a strong synergistic action with the tumour promoter, 12-O-tetradecanoyl-13-acetate (TPA), in stimulating DNA synthesis in separated T (but not non-T) cell fractions, and in unfractioned mononuclear cells. These results reconcile most of the conflicting reports in the literature concerning the interaction of WGA with human lymphocytes.     

Growth of children from 0-5 years: with special reference to mother's smoking in pregnancy

A cohort of 1163 pregnant women in two small towns in South Wales, UK, was identified and followed until the children born to them were five years of age. Growth in these children is described and a number of determinants identified. Social-class differences were very small at birth but differences in height became clear by the age of two years and in head circumference before this. In height the differences were largely accounted for by greater growth in social class I, but there was a gradient in head circumference throughout all the social classes. The social class effects gradually increased as the children became older. Parity of the mothers had a small effect on size at birth but age of the mother had no effect once parity was allowed for. Data on illnesses in the children were collected but no effect on growth could be detected. By far the most important determinant of growth which could be controlled is maternal smoking. About 40% of the women smoked, about 17% heavily (15 or more cigarettes per day) and the prevalence of smoking altered little during pregnancy. There was a graded effect of smoking on growth up to a 9% deficit in birth-weight, a 2% deficit in length at birth and a 1.5% deficit in head circumference in the babies born to the mothers who smoked most heavily (25 or more cigarettes per day) compared with non-smokers. There effects decreased with age but there were still residual effects at age five years.     

Do plain plastic and copper bearing intrauterine contraceptive devices have a central mechanism of action?

The notion that the intrauterine contraceptive device (IUCD) has a central, as well as a local action, is examined. Although the IUCD undoubtedly has a local action, certain IUCD related side effects, e.g. galactorrhoea, bloating and premenstrual syndrome and inadequate luteal function can be explained if the IUCD has some central action. The powerful postcoital anti-fertility effect of both copper-bearing and plain plastic IUCDs probably also depends to some extent on a central action. The central action of the IUCD is probably due to initiation of reflex hypothalamic activity following intrauterine reflex stimulation. The hypothalamic response to IUCD insertion consists of release of beta-endorphin accompanied by raised levels of prolactin, vasopressin and oxytocin.